Wada M, Kikuchi Y, Doy M
Department of Radiology, Tsukuba Medical Center Hospital, Ibaraki, Japan.
AJR Am J Roentgenol. 1990 Aug;155(2):283-7. doi: 10.2214/ajr.155.2.2115252.
To determine the sonographic features of uncomplicated acute diverticulitis of the cecum and ascending colon, the sonographic findings in 534 patients who presented with right lower quadrant pain were reviewed. Of these, 18 patients had uncomplicated acute diverticulitis of the cecum and ascending colon. The diagnosis was confirmed by surgery (one patient), clinical course (17 patients), CT (eight patients), or contrast enema (11 patients). On sonography, a round or oval focus of varying echogenicity, which protruded from a segmentally thickened colonic wall and was surrounded by a hyperechoic area, was seen in all 18 patients. These were hypoechoic foci (12 patients), hypoechoic foci with internal strong echoes (three patients), and echogenic shadowing foci with surrounding hypoechoic bands (three patients). Extraluminal gas (one patient) and thickening of lateroconal fascia (six patients) were seen also. Findings of enlarged appendix, frank abscess, and ascites were absent. All patients, including the one who had laparotomy, were successfully treated medically for diverticulitis. Of 515 patients without diverticulitis, in only one patient with acute appendicitis did sonography show a hypoechoic protruding focus. Our experience indicates that the major sonographic finding in patients with uncomplicated acute diverticulitis of the right colon is a hypoechoic round or oval focus protruding from a segmentally thickened colonic wall.
为确定单纯性盲肠和升结肠急性憩室炎的超声特征，我们回顾了534例右下象限疼痛患者的超声检查结果。其中，18例患有单纯性盲肠和升结肠急性憩室炎。诊断通过手术（1例患者）、临床病程（17例患者）、CT（8例患者）或钡剂灌肠（11例患者）得以证实。超声检查时，在所有18例患者中均可见一个从节段性增厚的结肠壁突出、回声各异的圆形或椭圆形病灶，其周围有高回声区。这些病灶包括低回声病灶（12例患者）、内部有强回声的低回声病灶（3例患者）以及周围有低回声带的回声增强伴声影病灶（3例患者）。还可见肠腔外气体（1例患者）和侧锥筋膜增厚（6例患者）。未发现阑尾肿大、明显脓肿及腹水。所有患者，包括接受剖腹手术的那例患者，均通过药物成功治疗了憩室炎。在515例无憩室炎的患者中，只有1例急性阑尾炎患者的超声检查显示有一个低回声突出病灶。我们的经验表明，右半结肠单纯性急性憩室炎患者的主要超声表现是从节段性增厚的结肠壁突出的低回声圆形或椭圆形病灶。
